Mistakes to Avoid When Billing Under PDGM: A Comprehensive Guide The Patient-Driven Groupings Model (PDGM) was implemented by the Centers for Medicare & Medicaid Services (CMS) on January 1, 2020, replacing the former Home Health Prospective Payment System (HH PPS). Designed to better align home health payments with patient characteristics, PDGM provides a more nuanced approach to reimbursement based on clinical, functional, and behavioral data. While PDGM aims to improve patient outcomes and provide more [...]

PDGM Billing for Home Health Agencies: Preparing for Audits and Reviews In the ever-evolving world of healthcare reimbursement, the Patient-Driven Groupings Model (PDGM) stands as one of the most significant changes for home health agencies in recent years. The PDGM, implemented by the Centers for Medicare and Medicaid Services (CMS) in 2020, drastically restructured the way home health services are paid, aiming to improve patient outcomes, reduce unnecessary spending, and streamline billing. While the PDGM [...]

How Home Health Agencies Can Stay Compliant with PDGM Billing Requirements The Patient-Driven Groupings Model (PDGM) introduced by the Centers for Medicare and Medicaid Services (CMS) in January 2020 fundamentally altered the way home health agencies (HHAs) approach billing. Designed to improve payment accuracy, PDGM requires that HHAs adapt to a more complex system, where payment is based on patient characteristics and clinical information rather than volume of visits. However, maintaining compliance with the stringent [...]

PDGM Billing: Why Accurate OASIS Assessments Matter The Patient-Driven Groupings Model (PDGM) was introduced by the Centers for Medicare & Medicaid Services (CMS) as a way to reform the home health payment system. It replaced the former Prospective Payment System (PPS) on January 1, 2020, with the goal of improving the accuracy and fairness of payments to home health agencies (HHAs). Under PDGM, reimbursement is determined based on patient characteristics and clinical information, rather than [...]

Nutrition for Active Seniors: Maintaining Strength and Vitality As we age, maintaining an active lifestyle becomes more important than ever. Staying physically active helps seniors retain their strength, mobility, and independence. However, the benefits of regular exercise, whether it’s walking, swimming, or strength training, can be optimized with the right nutrition. For active seniors, fueling the body with the proper nutrients is essential for maintaining energy levels, promoting muscle growth and repair, and supporting overall [...]